Cardiorespiratory Fitness Reference Standards and Prognostic Stratification in Chinese Patients With Cardiovascular...

Area of Science:

• Cardiology
• Preventive Medicine
• Clinical Exercise Physiology

Background:

• Cardiorespiratory fitness (CRF) is crucial for risk stratification in cardiovascular disease (CVD).
• Current CRF assessment in Chinese CVD patients uses non-specific standards, risking misclassification.
• Establishing tailored reference standards is vital for accurate risk assessment.

Purpose of the Study:

• To develop specific CRF reference standards for Chinese patients with CVD.
• To evaluate the utility of these standards in stratifying major adverse cardiovascular event (MACE) risk.

Main Methods:

• A multicenter retrospective study of 56,495 Chinese CVD patients (2018-2024).
• Derived sex- and age-specific CRF percentiles, comparing them to healthy adults.
• Validated prognostic performance for MACE using Kaplan-Meier and Cox regression in 6,317 patients.

Main Results:

• Established CRF reference standards showed significant differences across sex, age, and CVD subtype.
• Chinese CVD patients exhibited lower peak oxygen uptake (73.3%-84.0% of healthy levels).
• Lower CRF significantly correlated with increased MACE risk (HR 1.46-2.29) and reduced event-free survival.

Conclusions:

• The study presents the first CRF reference standards for Chinese CVD patients.
• These standards effectively stratify MACE risk, enhancing prognostic accuracy.
• Findings support data-driven functional risk assessment and personalized secondary prevention strategies.